Prescribing Competence of Canadian Medical Graduates: National Survey of Medical School Leaders

Author:

Holbrook Anne M.123ORCID,Lohit Simran2,Chang Oswin2ORCID,Deng Jiawen2ORCID,Perri Dan12,Dhhar Gousia1,Levine Mitchell123,Rudkowski Jill4,McLeod Heather5,Rigg Kaitlynn16,Telford Victoria2ORCID,Levinson Anthony J.7ORCID

Affiliation:

1. Division of Clinical Pharmacology and Toxicology, Department of Medicine, McMaster University, c/o SJHH, 50 Charlton Ave E, Hamilton, ON L8N 4A6, Canada

2. Clinical Pharmacology & Toxicology Research, Research Institute of St. Joes Hamilton, St. Joseph’s Healthcare, Hamilton, ON L8N 4A6, Canada

3. Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON L8N 4A6, Canada

4. Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON L8N 4A6, Canada

5. Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton, ON L8N 4A6, Canada

6. Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON L8N 4A6, Canada

7. Division of e-Learning Innovation, McMaster University, Hamilton, ON L8N 4A6, Canada

Abstract

Suboptimal knowledge of clinical pharmacology, therapeutics, and toxicology (CPT) and poor-quality prescribing are threats to patient safety. Our previous national survey of medical faculty identified limited confidence in medical student graduates’ ability to safely prescribe, as well as an interest in a national prescribing competence assessment. Given the in-person challenges posed by the restrictions related to the COVID-19 pandemic, we aimed to re-evaluate opinions and gauge the interest in e-learning resources and assessments. Using public sources, a sampling frame of medical school leaders from all 17 Canadian medical schools, including deans, vice-deans, and program directors for clerkship, residency, and e-learning, were invited to participate in a cross-sectional survey. Survey questions were finalized after several rounds of testing, and analyses were descriptive. Of 1448 invitations, 411 (28.4%) individuals reviewed the survey, and, among them, 278 (67.6%) completed at least one survey question, with representation from all schools. While more than 90% of respondents agreed that medical students should meet a minimum standard of prescribing competence, only 17 (7.9%) could vouch for their school meeting objectives in CPT, and many had significant concerns about their own or other schools’ recent graduate prescribing abilities. Given the lack of local CPT e-curricula resources, there was strong interest in a national online course and assessment in CPT. Our national survey results suggest an ongoing inadequacy of medical trainees’ prescribing competence, and also provide a strong endorsement for both a national online CPT course and assessment during medical school.

Funder

Government of Ontario

Publisher

MDPI AG

Reference37 articles.

1. Holbrook, A. (2023, May 16). What Is Clinical Pharmacology and Toxicology (CPT)?. Available online: https://ecampusontario.pressbooks.pub/clinicalpharmacologyandprescribingskillsformedicine/chapter/chapter-1/.

2. (2023, May 16). An in Depth Investigation into Causes of Prescribing Errors by Foundation Trainees in Relation to Their Medical Education—EQUIP Study, Available online: https://psnet.ahrq.gov/issue/depth-investigation-causes-prescribing-errors-foundation-trainees-relation-their-medical.

3. Prevalence, Incidence and Nature of Prescribing Errors in Hospital Inpatients: A Systematic Review;Lewis;Drug Saf.,2009

4. What is the scale of prescribing errors committed by junior doctors? A systematic review;Ross;Br. J. Clin. Pharmacol.,2009

5. Hoskins, E. (2023, February 11). A Prescription for Canada: Achieving Pharmacare for All—Final Report of the Advisory Council on the Implementation of National Pharmacare. Available online: https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/implementation-national-pharmacare/final-report.html.

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